People are skipping their statins because of silly claims online. Avoid “statin denial.” The health benefits of statins are well-established. Also, never skip your medication without talking to your doctor!
If you have high cholesterol, your doctor probably urged you to eat more vegetables and healthy fats, cut out saturated fats, lose extra pounds, and exercise more. And you know those moves would be good for your health overall.
You may also have been offered a prescription for a statin, a common drug that brings down cholesterol. Statins arrived on the scene in 1987. Over the next three decades, American deaths from heart disease dropped by about half — a huge public health success. Statins were key to that success, notes Steven E. Nissen, MD, from the well-known Cleveland Clinic, observing that reported rates of high cholesterol also dropped dramatically.
Still, many people dislike taking medication. You might refuse your doctor’s offer or skip taking your statin. Some people opt for a supplement instead. You’ll see dramatic claims for all kinds of “natural” supplements to reduce high cholesterol levels online — often alongside unproven scare stories about statins. But unlike drug manufacturers, people who sell supplements do not have to back up their statements with research.
Statins, on the other hand, have been studied extensively. In an exhaustive analysis of 135 randomized controlled trials, a report in a journal published by the American Heart Association concluded that the health benefits of statins outweigh the risks for most people, and side effects were uncommon. Statins do increase your risk of type 2 diabetes, so you should talk to your doctor about your habits and family history of both heart disease and diabetes.
If you do take a statin and seem to experience a side effect, don’t assume you should quit. Often the problem wasn’t really caused by the statin, and patients who go off later restart and do fine. Quitting forever is riskier, according to a large study of more than 28,000 patients who experienced a side effect. Nearly 30 percent stopped taking any statin over the next 12 months.
How well did they do compared to patients who continued? That’s a good test of the health benefits of statins. When researchers analyzed records from four years later, it turned out that the people who dropped the prescription were from 10 to 20 percent more likely to have a stroke or die.
Among patients who switched from one statin to another, large majorities were able to tolerate the second drug. Among those who had another side effect, most ended up staying on one statin or another. Those results suggest that to reap the health benefits of statins, it pays to keep trying.
But what about a “natural” alternative? Supplement-sellers use the word “natural” as a lure. They know how many Americans mourn that our commuting-fast-food lives have gotten out of touch with the earth that sustains us. But no manufactured, packaged product is straight from “nature.” Produce from a farmer’s market comes a lot closer. Taking a supplement might make you feel less guilty, but it doesn’t address the real problem.
It makes more sense to consider tackling high cholesterol through diet and exercise a “natural” remedy. You can also take a statin — you don’t have to choose.
Here’s a common-sense approach: Each time you put your statin in your mouth, consider it a reminder to eat oatmeal instead of a bacon and cheese sandwich for breakfast — what reminder would work for you? Make the ritual part of your plan to live more healthily. That way you’ll enjoy the health benefits of statins, while protecting yourself from diabetes, boosting your general health, and living in line with your values.
February 20, 2018
Christopher Nystuen, MD, MBA